Role of cyclooxygenase-2, ezrin and matrix metalloproteinase-9 as predictive markers for recurrence of basal cell carcinoma.

CONTEXT: Recurrence of basal cell carcinoma (BCC) may form a prognostic problem that couldn't be fully predicted. Although there are different clinical and histologic risk factors for BCC recurrence, few reports are available for the role of biologic markers.

AIM: The aim of this study was to assess the value of Cyclooxygenase-2 (COX-2), Ezrin and Matrix metalloproteinase-9 (MMP-9) in recurrence of BCC.

SETTINGS AND DESIGN: A retrospective controlled study.

MATERIALS AND METHODS: Primary tumors of 22 patients who had recurrent basal cell carcinoma (R-BCC) and 22 matched controls that showed non-recurrent basal cell carcinoma (NR-BCC) were collected. Clinical, histopathological, and immunohistochemical results were recorded and analyzed.

STATISTICAL ANALYSIS USED: SPSS software version 13 and Pearson χ2 test.

RESULTS: R-BCC showed COX-2 expression in 20 (90.9%) cases compared to 13 (59.1%) in NR-BCC with a significant difference (P = 0.04). Moderate to strong intensity was recorded in 13 recurrent and two non-recurrent tumors. Higher frequency for Ezrin immunopositivity was noted in R-BCC (72.7%) than NR-BCC (40.9%), but the difference did not reach the level of significance (P = 0.07). Twelve R-BCC and three NR-BCC revealed moderate to strong staining. For MMP-9, there was no statistically significant difference (P = 1) between recurrent cases (63.6%) and controls (68.2%). No correlation was found between marker expressions and clinical or histologic features of R-BCC.

CONCLUSIONS: Biologic markers may have a promising role in assessment of BCC prognosis and early detection of recurrence. High COX-2 expression could be considered as a risk factor of BCC recurrence that can be added to other clinical and histologic factors.